Provider Demographics
NPI:1164246898
Name:BEADLES OPERATIONS, LLC
Entity type:Organization
Organization Name:BEADLES OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPH, LNHA
Authorized Official - Phone:580-430-3383
Mailing Address - Street 1:730 SHARE DR
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-3616
Mailing Address - Country:US
Mailing Address - Phone:580-430-3324
Mailing Address - Fax:580-430-3349
Practice Address - Street 1:730 SHARE DR
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-3616
Practice Address - Country:US
Practice Address - Phone:580-430-3324
Practice Address - Fax:580-430-3349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility